674 권순재ㆍ정연중ㆍ윤현진ㆍ목종수ㆍ권지영,.., (Watts et al., 2017)., 70% (Kummerer, 2009). (Witte, 2000)., (Souli et al., 2008)., % ,113 (NIFS, 2017
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1 한수지 51(6), , 2018 Original Article Korean J Fish Aquat Sci 51(6), ,2018 용남광도해역의굴 (Crassostrea gigas) 및육상오염원에서분리한대장균 (Escherichia coli) 의항생제내성 권순재 정연중 윤현진 목종수 1 권지영 * 국립수산과학원남동해수산연구소, 1 국립수산과학원식품위생가공과 Antimicrobial Resistance in Escherichia coli Isolated from Oyster Crassostrea gigas and Inland Pollution Sources in the Yongnam-Gwangdo Area, Korea Soon Jae Kwon, Yeoun Joong Jung, Hyun Jin Yoon, Jong Soo Mok 1 and Ji Young Kwon* Southeast Sea Fisheries Research Institute, National Institute of Fisheries Science, Tongyeong 53085, Korea 1 Food Safety and Processing Research Division, National Institute of Fisheries Science, Busan 40683, Korea We isolated and characterized Escherichia coli (E. coli) from oyster Crassostrea gigas and inland pollution sources on Yongnam-Gwangdo island and neighboring areas on the southern coast of Korea in A total of 222 strains of E. coli were isolated from 132 oysters and 88 samples from inland pollution sources. These 222 isolates were tested for their susceptibility to 24 antimicrobial agents, and 221 isolates were found resistant to the tested antibiotics. Of these 99.5% and 70.7% of the isolates showed very high resistance to rifampin and cephalothin respectively, followed by tobramycin (23.4%), streptomycin (20.2%), tetracycline (19.4%), cefepime (18.9%), ceftazidime (18.9%) and nalidixic acid (16.7%). The resistance rate of E. col isolated from oysters was higher than that from inland pollution sources. In addition, multiple resistance to at least four antibiotics were present in 73.2% and 26.5% of E. coli isolates from oysters and inland pollution source samples, respectively. Key words: Oyster, Antimicrobial resistance, Inland pollution source, Escherichia coli 서론 (Todd and Campbell, 2002). Escherichia coli, (Song et al., 2004). (Crassostrea gigas) (Sobsey and Jaykus, 1991).,., (Son et al., 2003). (Angulo et al., 2000; Donabedian et al., 2003).. *Corresponding author: Tel: Fax: address: kjy3t3@korea.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial Licens ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Korean J Fish Aquat Sci 51(6), , December 2018 Received 20 November 2018 Revised 5 December 2018; Accepted 20 December 2018 저자직위 : 권순재 ( 인턴연구원 ), 정연중 ( 해양수산연구사 ), 윤현진 ( 인턴연구원 ), 목종수 ( 해양수산연구관 ), 권지영 ( 해양수산연구사 ) Copyright 2018 The Korean Society of Fisheries and Aquatic Science 673 pissn: , eissn:
2 674 권순재ㆍ정연중ㆍ윤현진ㆍ목종수ㆍ권지영,.., (Watts et al., 2017)., 70% (Kummerer, 2009). (Witte, 2000)., (Souli et al., 2008)., % ,113 (NIFS, 2017).,.,. 재료및방법 시료채취및운반 (Fig. 1). 132 whirl-pak (Nasco International Inc., USA). 11, Fig. 1. Sampling stations of oyster Crassostrea gigas ( ) and inland pollution sources ( ) in the Yongnam-Gwangdo area, Korea.. 대장균 (E. coli) 분리및동정 E. coli The recommended procedures for the examination of seawater and shellfish (APHA, 1970). (phosphate buffer solution),. 10 ml lauryl tryptose broth (LTB; Difco, Detroit, MI, USA) (35 0.5, 48 ), loop (10 L) 10 ml EC broth (EC; Difco, Detroit, MI, USA), (44.5, 24 ). EC broth tryptone bile X-glucuronide Table 1. Number of E. col isolated from oyster Crassostrea gigas and inland pollution sources in the Yongnam-Gwangdo area Samples No. of samples No. of isolated strains Oyster Inland pollution source Total
3 분리된대장균 (Escherichia coli) 의항생제내성 675 agar (TBX; Oxoid, Basingstoke, UK) streak ( ), E. coli VITEK system (Biomerieux, Marcy, France),. 항생제내성시험 E. coli Acar and Goldstein (1991)., E. coli muller hinton broth (MHB; BBL, NJ, USA) , densicheck plus (Biomerieux, Marcy, France) mm muller hinton II agar (MHA; BBL, NJ, USA) 5 15 (Sensi-disc, BBL, NJ, USA). amikacin (30 g; AN), amoxicillin/ clavulanic acid (30 g; AmC), ampicillin (10 g; AM), aztreonam (30 g; ATM), cefamandole (30 g; MA), cefazolin (30 g; CZ), cefepime (30 g; FEP), cefotaxime (30 g; CTX), cefotetan (30 g; CTT), cefoxitin (30 g; FOX), ceftazidime (30 g; CAZ), cephalothin (30 g; CF), chloramphenicol (30 g; C), ciprofloxacin (5 g; CIP) gentamicin (10 g; GM), imipenem (10 g; IPM), nalidixic acid (30 g; NA), piperacillin (100 g; PIP), rifampin (5 g; RA), streptomycin (10 g; S), tetracycline (30 g; TE), tobramycin (10 g; NN), trimethoprim (5 g; TMP), trimethoprim/ sulfamethoxazole (1.25/ g; SXT) 24. muller hinton II Agar , (inhibition zone). 결과및고찰 대장균의항생제내성 Table 2. Antimicrobial resistance of E. col isolated in the Yongnam-Gwangdo area Antimicrobial agents Concentration per disk (μg) Diffusion zone breakpoint (mm) No. of resistance isolates (%) Escherichia coli (n=222) Amikacin (AN) 30 <14 31 (13.9) Amoxicillin/Clavulanic acid (AMC) 20/10 <13 6 (2.7) Ampicillin (AM) 10 <13 10 (4.5) Aztreonam (ATM) 30 <10 5 (2.5) Cefamandole (MA) 30 <14 17 (7.7) Cefazolin (CZ) 30 <14 12 (5.4) Cefepime (FEP) 30 <14 42 (18.9) Cefotetan (CTT) 30 <12 1 (0.4) Cefotaxine (CTX) 30 <14 7 (3.2) Ceftazidime (CAZ) 30 <14 42 (18.9) Cephalothin (CF) 30 < (70.7) Cefoxitin (FOX) 30 <14 6 (2.7) Chloramphenico (C) 30 <12 15 (6.8) Ciprofloxacin (CIP) 5 <15 11 (5.0) Gentamicin (GM) 10 <12 14 (6.3) Imipenem (IPM) 10 <13 0 (0.0) Nalidixic acid (NA) 30 <13 37 (16.7) Piperacillin (PIP) 10 <17 32 (14.4) Rifampin (RA) 5 < (99.5) Streptomycin (S) 10 <11 45 (20.2) Tetracycline (TE) 19 <14 43 (19.4) Trimethoprim/ Sulfamethoxazole (SXT) 23.75/1.25 <10 16 (7.2) Tobramycin (NN) 10 <12 52 (23.4) Trimethoprim (TMP) 5 <10 18 (8.1)
4 676 권순재ㆍ정연중ㆍ윤현진ㆍ목종수ㆍ권지영 E. coli 56, ( 10, 1 ) 166 (Table 1), E. coli (Table 2), rifampin (99.5%) cephalothin (70.7%), tobramycin (23.4%), streptomycin (20.2%), tetracycline (19.4%), cefepime (18.9%), ceftazidime (18.9%), nalidixic acid (16.7%), piperacillin (14.4%), amikacin (13.9%). trimethoprim, cefamandole, trimethoprim/ sulfamethoxazole, chloramphenicol, gentamicin, cefazolin. ciprofloxacin, ampicillin, cefoxitin, amoxicillin/ clavulanic acid, cefoxitim, aztreonam, cefotetan 10%, imipenem., (,, ) E. coli tetracycline (29.9%), streptomycin (25.5%), ampicillin (18.6%) (Park et al., 2013), 2013 (,, ) E. coli tetracycline (10.6%) 5% (Park et al., 2018) E. coli ampicillin (37.2%), cephalothin (21.7%), cefazolin (19.9%) (Jo et al., 2016) tetracycline 4% cephem E. coli ansamycin rifampin cephem cephalothin, tetracycline penicillin (MFDS, 2018) 2014 Table 3. Antimicrobial resistance of E. col isolated from oyster Crassostrea gigas and inland pollution sources in Yongnam-Gwangdo area Antimicrobial agents Concentration per disk (μg) Diffusion zone breakpoint (mm) No. of resistance isolates (%) Oyster Inland pollution source E. coli (n=56) E. coli (n=166) Amikacin (AN) 30 <14 2 (3.6) 8 (4.8) Amoxicillin/Clavulanic acid (AMC) 20/10 <13 1 (1.8) 5 (3.0) Ampicillin (AM) 10 <13 8 (14.3) 23 (13.9) Aztreonam (ATM) 30 <10 0 (0.0) 5 (3.0) Cefamandole (MA) 30 <14 0 (0.0) 17 (10.2) Cefazolin (CZ) 30 <14 0 (0.0) 5 (3.0) Cefepime (FEP) 30 <14 40 (71.4) 2 (1.2) Cefotetan (CTT) 30 <12 1 (1.8) 0 (0.0) Cefotaxine (CTX) 30 <14 0 (0.0) 7 (4.2) Ceftazidime (CAZ) 30 <14 40 (71.4) 2 (1.2) Cephalothin (CF) 30 <14 41 (73.2) 116 (69.9) Cefoxitin (FOX) 30 <14 0 (0.0) 6 (3.6) Chloramphenico (C) 30 <12 6 (10.7) 9 (5.4) Ciprofloxacin (CIP) 5 <15 1 (1.8) 10 (6.0) Gentamicin (GM) 10 <12 2 (3.6) 12 (7.2) Imipenem (IPM) 10 <13 0 (0.0) 0 (0.0) Nalidixic acid (NA) 30 <13 7 (12.5) 30 (18.1) Piperacillin (PIP) 10 <17 6 (10.7) 26 (15.7) Rifampin (RA) 5 <17 56 (100.0) 165 (99.4) Streptomycin (S) 10 <11 8 (14.3) 37 (22.3) Tetracycline (TE) 19 <14 12 (21.4) 31 (18.7) Trimethoprim/ Sulfamethoxazole (SXT) 23.75/1.25 <10 4 (7.1) 12 (7.2) Tobramycin (NN) 10 <12 40 (71.4) 12 (7.2) Trimethoprim (TMP) 5 <10 6 (10.7) 12 (7.2)
5 분리된대장균 (Escherichia coli) 의항생제내성 677. E. coli,, (Kim et al., 2008; Jang et al., 2017; Lee et al., 2017), (Ferreira et al., 2007; Peak et al., 2007; Reinthaler et al., 2010) (,,, )., 47%,,,,, 89.3% (NIFS, 2017). E. coli ( ) ansamycin rifampin (99.5%), cephem cephalothin (70.7%), cefepime (18.9%) ceftazidime (18.9%), aminoglyciside tobramycin (23.4%) streptomycin (20.2%) (Kim et al., 2016; Kim et al., 2017). E. coli tetracycline, E. coli quinolon nalidixic acid 90% nalidixic acid (16.7%) Table 4. Multiple antimicrobial resistance of E. col isolated from oyster Crassostrea gigas in Yongnam-Gwangdo Area No. of antimicrobials Resistance patterns No. of isolated strains Total (%) 1 RA AM, RA 1 CF, RA 3 CTT, RA 1 RA, TE 1 TMP, RA 1 AMC, AN, RA 1 CF, AN, RA 1 CF, TMP, RA 1 FEP, NN, CAZ, RA 4 GM, S, TMP, RA 1 5 CF, FEP, NN, CAZ, RA AM, CF, FEP, NN, CAZ, RA 3 CF, FEP, NN, CAZ, RA, C 1 CF, GM, FEP, NN, CAZ, RA 1 CF, FEP, NA, NN, CAZ, RA, TE 2 CF, S, FEP, NN, CAZ, RA, TE 2 8 CF, S, FEP, NN, CAZ, RA, C, TE AM, CF, S, FEP, PIP, NN, CAZ, RA, TE AM, CF, S, FEP, PIP, NN, CAZ, RA, C, TE AM, CF, AN, FEP, NA, PIP, TMP, NN, CAZ, RA, SXT 1 AM, CF, FEP, NA, PIP, TMP, NN, CAZ, RA, TE, SXT 1 AM, CF, S, FEP, NA, PIP, NN, CAZ, RA, C, TE 1 12 AM, CF, S, FEP, NA, PIP, TMP, NN, CAZ, RA, TE, SXT AN, Amikacin; AMC, Amoxicillin/Clavulanic acid; AM, Ampicillin; ATM, Aztreonam; MA, Cefamandole; CZ, Cefazolin; FEP, Cefepime; CTX, Cefotaxime; CTT, Cefotetan; FOX, Cefoxitin; CAZ, Ceftazidime; CF, Cephalothin; C, Chloramphenicol; CIP, Ciprofloxacin; GM, Gentamicin; IPM, Imipenem; NA, Nalidixic acid; PIP, Piperacillin; RA, Rifampin; S, Streptomycin; TE, Tetracycline; NN, Tobramycin; TMP, Trimethoprim; SXT, Trimethoprim/Sulfamethoxazole
6 678 권순재ㆍ정연중ㆍ윤현진ㆍ목종수ㆍ권지영 Table 5. Multiple antimicrobial resistance of E. col isolated from inland pollution source in Yongnam-Gwangdo Area No. of antimicrobials Resistance patterns No. of isolated strains RA AN, RA 3 CF, RA 50 MM, RA 1 NA, RA 5 RA, C 2 RA, FOX 2 RA, TE 2 AN, NA, RA 1 CF, MA, RA 8 CF, NN, RA 1 CF, RA, TE 7 CF, S, RA 12 S, AN, RA 2 AM, CF, PIP, RA 2 AM, CF, S, RA 1 CF, GM, RA, FOX 1 CF, NA, RA, CIP 2 CF, NA, RA, TE 1 CF, PIP, RA, TE 1 CF, RA, C, TE 1 CF, S, NN, RA 1 CF, S, RA, TE 3 CF, RA, TE, CIP 1 GM, S, RA, TE 1 S, AN, NA, RA 1 AN, CF, GM, PIP, RA 1 AM, CF, NA, PIP, RA 1 AM, CF, PIP, RA, C 1 CF, S, AN, AMC, RA 1 CF, S, MA, RA, TE 1 AM, CF, NA, PIP, RA, TE 1 AM, CF, S, PIP, RA, FOX 1 CF, S, AN, PIP, RA, TE 1 CF, S, MA, RA, C, TE 1 CZ, CF, S, AM, RA, FOX 1 AN, Amikacin; AMC, Amoxicillin/Clavulanic acid; AM, Ampicillin; ATM, Aztreonam; MA, Cefamandole; CZ, Cefazolin; FEP, Cefepime; CTX, Cefotaxime; CTT, Cefotetan; FOX, Cefoxitin; CAZ, Ceftazidime; CF, Cephalothin; C, Chloramphenicol; CIP, Ciprofloxacin; GM, Gentamicin; IPM, Imipenem; NA, Nalidixic acid; PIP, Piperacillin; RA, Rifampin; S, Streptomycin; TE, Tetracycline; NN, Tobramycin; TMP, Trimethoprim; SXT, Trimethoprim/Sulfamethoxazole. Total (%)
7 분리된대장균 (Escherichia coli) 의항생제내성 679 Table 5. Continued No. of antimicrobials 7 8 Resistance patterns No. of isolated strains AM, GM, S, NA, RA, TE, CIP 1 AM, S, PIP, TMP, RA, TE, SXT 1 GM, PIP, TMP, MA, RA, TE, CIP 1 AM, CZ, CF, PIP, MA, RA, TE, CTX 1 AM, CZ, CF, PIP, TMP, RA, TE, SXT 1 9 AM, CZ, CF, NA, PIP, ATM, MA, RA, CTX AM, CF, NA, PIP, TMP, NN, RA, C, TE, SXT 1 S, PIP, ATM, NN, MA, RA, TE, CTX, CIP, SXT 1 AM, CZ, CF, GM, NA, PIP, ATM, MA, RA, CTX, CIP 1 AM, CZ, CF, S, AMC, NA, PIP, TMP, MA, RA, SXT 3 CF, GM, S, NA, PIP, TMP, NN, MA, RA, C, STX 1 AM, CF, GM, S, NA, PIP, TMP, NN, RA, C, TE, CIP, SXT 1 AM, CZ, CF, GM, S, NA, PIP, NN, MA, RA, TE, CTX, CIP 1 AM, CZ, CF, GM, FEP, NA, PIP, TMP, ATM, NN, MA, RA, CTX, SXT 1 AM, CZ, CF, GM, S, PIP, TMP, NN, MA, CAZ, RA, TE, FOX, SXT 1 17 AM, CZ, CF, GM, FEP, NA, PIP, TMP, ATM, NN, MA, CAZ, RA, TE, CTX, CIP, SXT Total AN, Amikacin; AMC, Amoxicillin/Clavulanic acid; AM, Ampicillin; ATM, Aztreonam; MA, Cefamandole; CZ, Cefazolin; FEP, Cefepime; CTX, Cefotaxime; CTT, Cefotetan; FOX, Cefoxitin; CAZ, Ceftazidime; CF, Cephalothin; C, Chloramphenicol; CIP, Ciprofloxacin; GM, Gentamicin; IPM, Imipenem; NA, Nalidixic acid; PIP, Piperacillin; RA, Rifampin; S, Streptomycin; TE, Tetracycline; NN, Tobramycin; TMP, Trimethoprim; SXT, Trimethoprim/Sulfamethoxazole. Total (%) , E. coli. 대장균의항생제내성비교 E. coli Table 3. E. coli 24 18, rifampin (100%), cephalothin (73.2%), cefepime (71.4%), ceftazidime (71.4%), tobramycin (71.4%), 20%. 22 rifampin (99.4%), cephalothin (69.9%) 20%., (Grimes, 1991; Feldhusen, 2000). aztreonam (5%), cefamandole (17%), cefazolin (5%), cefotaxime (7%), cefoxitin (6%) E. coli, 대장균의다제내성양상 E. coli 56 Table , (multiple antimicrobial resistance bacteria, MARB) 41 (73.2%), 5 (rifampin, cephalothin, cefepime, ceftazidime, tobramycin) (35.7%). E. coli E. coli (14.2%, 15.9%) (Park et al., 2013; Jo et al., 2016), (62.5%) (Son et al., 2009).,
8 680 권순재ㆍ정연중ㆍ윤현진ㆍ목종수ㆍ권지영. E. coli,, E. coli. E. coli 84.7%-90.1% 69.4%- 87.0% (17.0%-31.9%) (15.2%-38.2%), (64.6%-87.4%) (52.3%-78.6%) (MFDS, 2018) E. coli. E. coli (166 ) (Table 5) rifampin cephalothin 30% (50 ), 26.5% (44 ),,,,, (, ), ( ), (Kim et al., 2008).,.. 사사 2018 (R ). References Acar JF and Goldstein FW Disk susceptibility testing. In: Antibiotics in Laboratory Medicine, Lorian V, ed. Williams & wilkins, Baltimore, M.D., U.S.A., Angulo FJ, Johnson KR and Tauxe RV Origins and consequences of antimicrobial-resistant nontyphoidal salmonella: implications for the use of fluoroquinolones in food animals. Mocrob Drug Resist 6, mdr APHA (American Public Health Association) Recommended procedures for the examination of seawater and shellfish. 4th Ed. American Public Health Association, Washington D.C., U.S.A., Donabedian SM, Thal LA and Hershberger E Molecular characterization of gentamicin-resistant Enterococci in the United States: evidence of spread from animals to humans through food. J Clin Microbiol 41, org/ /jcm Feldhusen F The role of seafood in bacterial foodborne disease. Microbes Infect 2, Ferreira M, Vaz-Moreira I, Gonzalez-Pajuelo M, Nunes OC and Mannaia CM Antimicirobial resistance patterns in Enterobacteriaceae isolated from an urban wastewater treatment plant. FEMS Microbiol Ecol 60, doi.org/ /j x. Grimes DJ Ecology of estuarine bacteria capable of causing human disease: A review. Estuaries 14, doi.org/ / Jang YJ, Yoo YJ, Sul WJ, Cha CJ, Rhee OJ and Chae JC Effect of antibiotic resistant factors in effluent of wastewater treatment plant on stream. Korean J Microbiol 53, Jo MR, Park YS, Park KBW, Kwon JY, Yu HS, Song KC, Lee HJ, Oh EG, Kim JH, Lee TS and Kim PH Antimicrobial resistance in Escherichia coli isolated from shellfish farms on the west coast of Korea. Korean J Fish Aquat Sci 49, KFAS Kim JA, Park JH, Kim BY and Kim DS The Trend of Acute Respiratory Tract Infections and Antibiotic Prescription Rates in Outpatient Settings using Health Insurance Data. Korean J Clin Pharm 27, org/ /kjcp Kim JH, Park CK, Kim MY and Ahn SG Contamination of Veterinary Antibiotics and Antimicrobials in Han River Basin. J Korean Soc Environ Anal 11, Kim YA, Park YS, Youk TM, Lee SS and Son YJ A Study on the Use of Antibiotics in Korea and the Resistance of Major pathogens to Antibiotics. NHIS Ilsan hospital Report , Kummerer K Antibiotics in the aquatic environment- A review-park I. Chemosphere 75, org/ /j.chemosphere Lee HJ, Kim HY, Kim KY, Yang DS, Lee IJ, Lim YK, Kim JH and Oh JE Characteristic Occurrence and Distributions of Pharmaceuticals in the Nakdong River. J Korean Soc Environ Eng 39, KSEE MFDS (Minstry of Food and Drug Safety) Antimicrobial resistance monitoring. Retrieved from go.kr/m_231/view.do?seq=33040 on Jul 10, 2018.
9 분리된대장균 (Escherichia coli) 의항생제내성 681 NIFS (National Institute of Fisheries Science) Report of sanitary survey of shellfish growing area in Yongnam- Gwangdo, NIFS, Busan, Korea. Park KBW, Kim SH, Ham IT, Ryu AR, Kwon JY, Kim JH, Yu HS, Lee HJ and Mok JS Antimicrobial resistance patterns of Escherichia coli isolated from discharged water from inland pollution sources in the Hansan-Heojeman and Jaranman-Saryangdo area of Korea. Korean J Fish Aquat Sci 51, Park KBW, Park JY, Jo MR, Yu HS, Lee HJ, Kim JH, Oh EG, Shin SB, Kim YK and Lee TS Antimicrobial resistance in Escherichia coli isolated from shellfish farms in the southern coast of Korea. Korean J Fish Aquat Sci 46, Peak N, Knapp CW, Yang RK, Hanfelt MM, Smith MS, Aga DS and Graham DW Abundance of six tetracycline resistance genes in wastewater lagoons at cattle feedlots with different antibiotic use stategies. Environ Microbiol 9, Reinthaler FF, Ferierl G, Galler H, Haas D, Leitner E, Mascher F, Melkes A, Posch J, Winter I, Zarfel G and Marth E ESBL-producing E. coli in Austrian sewage sludge. Water Res 44, Sobsey MD and Jaykus LA Human enteric viruses and depravation of bivalve molluscs. In: Molluscan shellfish depravation. Otwell WS, Rodrick GE and Martin RE, eds. CRC Press, Boca Raton, F.L., U.S.A., Son JC, Park SW and Min KJ Environmental and antimicrobial characteristics of Vibro spp. isolated from fish, shellfish and brackish water samples in Gyeonbuk western coast. Kor J Environ Health 29, Son KT, Oh EG, Park KBW, Kwon JY, Lee HJ, Lee TS and Kim J.H Antimicrobial susceptibility of Escherichia coli isolated from fish farms on the southern coast of Korea. Korean J Fish Aquat Sci 42, Song SW, Jung SC, Kim SI, Jung ME, Kim KH, Lee JY, Lim SK, Lee YJ, Cho NI, Park JM and Park YH Surveilance of antimicrobial susceptibility of bacteria isolated from slaughterhouse in Korea, Antimicrobial susceptibility of E. coli isolated from carcasses in slaughter house. Korean J Vet Public Health 25, Souli M, Galani I and Giamarellou H Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro Surveill 13, Todd KE and Campbell AR Growing area 1508 sanitary survey report. Marlborough Public Health Unit, Marlborough, New Zealand. Watts JEM, Schreier HJ, Lanska L and Hale MS The Rise Tide of Antimicribial Resistance in Aquaculture: Source, Sinks and Solutions. Mar Drugs 15, org/ /md Witte W Selective pressure by antibiotic use in livestock. Int J Antinicrob Agents 16, S19-S24. org/ /s (00)
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